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General NPI Number Information
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NPI Number | 1871612408
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Entity Type | Individual
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Provider Name | NOEL HENRY O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 02/07/2018
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Provider Practice Location Address
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Address Line | 2855 N OLD LAKE WILSON ROAD LOCATED INSIDE WALMART 5214
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City | KISSIMMEE
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State | FL
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Zip | 34747-1821
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Country | US
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Telephone | 407-654-0181
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Fax | 407-877-4471
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Provider Business Mailing Address
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Address Line | 13506 SUMMERPORT VILLAGE PKWY SUITE 254
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City | WINDERMERE
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State | FL
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Zip | 34786-7366
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Country | US
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Telephone | 954-288-3032
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Fax | 407-877-3276
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC3970
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License Number State | FL
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